CK上昇の鑑別

Causes of an elevated creatine kinase

Exercise related:
• Resistance type training
• Extreme exercise, eg, ultra-endurance sports
Exercise, trauma, diet

 

Muscle trauma:
• Seizures
• Surgery
• Other trauma including crush injuries

 

Alcohol excess
Thiamine deficiency

 

Drugs
Adrenergic stimulants, eg, MDMA, cocaine, amphetamines
Lipid lowering therapies:
• Statins (especially at high doses)
Cytochrome CYP3A4 interactions
▪ Fibrates

Macrolide antibiotics such as clarithromycin
Systemic antifungals, eg, ketoconazole

Dermatological therapies
• Systemic Retinoids

Oncologic drugs
• BRAF inhibitors, PD-L1 antagonists

Antiretroviral therapies for HIV
• Mitochondrial effects, eg, nucleoside analogueues
• Cytochrome metabolism interactions (especially with protease inhibitor-ritonavir combinations)

Rheumatological drugs
• Hydroxychloroquine, colchicine

Neurologic or psychiatric drugs, especially if related to neuroleptic malignant syndrome
• Clozapine
• Antipsychotics (eg, olanzapine)

 

Endocrine
Severe hypothyroidism (TSH >100 m IU/L)
Cushing’s disease
Acromegaly
Hyperparathyroidism
Hyperthyroidism (rare)

Autoimmune
Systemic lupus erythematosus
Rheumatoid arthritis
Polymyalgia rheumatica
Coeliac disease (myopathic form)
Dermatomyositis
Polymyositis
Immune mediated necrotising myopathy sporadic inclusion body myositis

Non-metabolic myopathy (eg, myotonic dystrophy, Duchenne muscular dystrophy, Becker
muscular dystrophy, inclusion-body myositis)
Metabolic myopathy (eg, glycogen storage disease)